Mortality following non-ST elevation acute coronary syndrome: 4 years follow-up of the PRAIS UK Registry (Prospective Registry of Acute Ischaemic Syndromes in the UK). | LitMetric
Clinical Trials and Evaluation Unit, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK.
Published: November 2004
AI Article Synopsis
Article Abstract
Aim: To present information on long-term prognosis and risk factors following an admission with non-ST elevation acute coronary syndrome.
Methods: A cohort of 653 patients was followed for mortality and causes of death using data from the UK Office of National Statistics (ONS). Cox proportional hazards model was used to identify the prognostic factors.
Results: Overall survival at a maximum follow-up of 45 months was 77.8% (95% CI 74.1-81.1%). Seventy-three per cent of the deaths were clearly due to a cardiovascular cause. Age, male gender, heart failure, ST depression or bundle branch block were all associated with higher short- and long-term risk. Taking aspirin or having a revascularization procedure, over the period of six months following initial hospitalisation were both associated with a lower long-term risk.
Conclusion: Non-ST elevation acute coronary syndromes carry a high risk of death over a 4-year period. Conventional risk factors can predict both short- and long-term risk. More invasive management and the use of evidence-based therapies appear to be associated with a lower risk.
Background: The optimal treatment for ischemic mitral regurgitation (IMR) in patients of non-ST elevation myocardial infarction (NSTEMI) is a debated topic.
Objective: To evaluate the long term outcome on patients with NSTEMI and IMR, particularly emphasizing the comparison of treatments in those with moderate to severe MR.
Methods: We enrolled patients with NSTEMI and classified non/trivial to mild regurgitation as insignificant IMR and moderate to severe regurgitation as significant IMR.
To assess the link between systemic immune-inflammation index (SII) and risk of major adverse cardiovascular events (MACE), contrast-induced nephropathy (CIN), and overall mortality in patients with acute myocardial infarction (AMI). Electronic search of PubMed, EMBASE, Web of Science, and Scopus databases was done for observational studies with the data on the association of SII and outcomes, such as MACE, and CIN in adult (≥18 y) patients with AMI. A random-effects model was used, and the pooled effect sizes were expressed as relative risk (RR) with corresponding 95% confidence intervals (CI).
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, 4th Floor William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
A study evaluated the effectiveness of invasive versus conservative treatment strategies in older women with non-ST-elevation acute coronary syndrome (NSTEACS), addressing the lack of representation of this group in clinical trials.
The analysis included 717 women and found that the invasive strategy showed a lower risk of myocardial infarction (MI) and urgent revascularization compared to the conservative approach, although it didn't significantly reduce overall mortality rates.
The findings suggest that while invasive treatment is beneficial for reducing MI in older women with NSTEACS, it does not impact the overall risk of death or other severe outcomes after one year.
Background: Coronary artery bypass grafting (CABG) provides superior long-term outcomes to percutaneous coronary intervention (PCI) for complex multivessel coronary artery disease (CAD). People with chronic kidney disease (CKD) have increased prevalence of multivessel CAD, but also increased surgical risk. We investigated whether CKD predicted real-world use of CABG, versus PCI, in patients revascularized for acute coronary syndrome (ACS).
A 73-year-old man with atrial fibrillation and coronary disease requiring stenting to the right coronary artery 7 months prior was admitted for observation after taking an extra dofetilide dose. Troponins trended upward, and electrocardiogram demonstrated QT prolongation to 502 ms as well as T-wave inversions. The patient underwent cardiac catheterization, which revealed severe distal left main disease.
